Using a Respectful Approach to Child-centred Healthcare (ReACH) in a paediatric clinical trial: A feasibility study

Background There is a growing momentum in paediatric ethics to develop respectful research and healthcare protocols. We developed, tested and refined our ‘Respectful Approach to Child-centred Healthcare’ (ReACH), to underpin respectful participant interactions in a clinical trial. Objective To determine whether a ReACH-based approach is acceptable to children and parents, and effective in obtaining compliance with common healthcare assessments in a clinical trial of healthy 4-6-year-old children. Methods ReACH-based child assessments were evaluated at two baseline clinics and one post-intervention, using mixed methods. Children (n = 49; 46.9% female; mean age = 5.24±0.88 years at baseline) and their parents provided independent evaluation, via customised 5-point Likert scales and qualitative feedback. A dedicated child researcher evaluated adherence to the study ReACH principles. Results Children achieved compliance rates of 95% for body composition (BodPod) assessments; 89% for blood pressure measurements, and 92% (baseline) and 87% (post-intervention) for blood draws. Adherence to ReACH principles during clinic visits was positively associated with child compliance, significantly for baseline BodPod (p = 0.002) and blood test (p = 0.009) clinics. Satisfaction with BodPod protocols was positively associated with compliance, for children at baseline (p = 0.029) and for parents post-intervention (p \u3c 0.001). Parents rated the study itself very highly, with 91.7% satisfied at baseline and 100% post-intervention. Qualitative feedback reflected an enjoyable study experience for both parents and children. Conclusions Adherence to our emerging ReACH approach was associated with high child compliance rates for common healthcare assessments, although no causality can be inferred at this preliminary stage of development. Participants expressed satisfaction with all aspects of the study. Our use of child-centred methods throughout a research intervention appears feasible and acceptable to children and their parents

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Multiplatform Analysis of 12 Cancer Types Reveals Molecular Classification within and across Tissues of Origin

Recent genomic analyses of pathologically-defined tumor types identify “within-a-tissue” disease subtypes. However, the extent to which genomic signatures are shared across tissues is still unclear. We performed an integrative analysis using five genome-wide platforms and one proteomic platform on 3,527 specimens from 12 cancer types, revealing a unified classification into 11 major subtypes. Five subtypes were nearly identical to their tissue-of-origin counterparts, but several distinct cancer types were found to converge into common subtypes. Lung squamous, head & neck, and a subset of bladder cancers coalesced into one subtype typified by TP53 alterations, TP63 amplifications, and high expression of immune and proliferation pathway genes. Of note, bladder cancers split into three pan-cancer subtypes. The multi-platform classification, while correlated with tissue-of-origin, provides independent information for predicting clinical outcomes. All datasets are available for data-mining from a unified resource to support further biological discoveries and insights into novel therapeutic strategies

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Soil carbon distribution in Alaska in relation to soil-forming factors

The direction and magnitude of soil organic carbon (SOC) changes in response to climate change remain unclear and depend on the spatial distribution of SOC across landscapes. Uncertainties regarding the fate of SOC are greater in high-latitude systems where data are sparse and the soils are affected by sub-zero temperatures. To address these issues in Alaska, a first-order assessment of data gaps and spatial distributions of SOC was conducted from a recently compiled soil carbon database. Temperature and landform type were the dominant controls on SOC distribution for selected ecoregions. Mean SOC pools (to a depth of 1-m) varied by three, seven and ten-fold across ecoregion, landform, and ecosystem types, respectively. Climate interactions with landform type and SOC were greatest in the uplands. For upland SOC there was a six-fold non-linear increase in SOC with latitude (i.e., temperature) where SOC was lowest in the Intermontane Boreal compared to the Arctic Tundra and Coastal Rainforest. Additionally, in upland systems mineral SOC pools decreased as climate became more continental, suggesting that the lower productivity, higher decomposition rates and fire activity, common in continental climates, interacted to reduce mineral SOC. For lowland systems, in contrast, these interactions and their impacts on SOC were muted or absent making SOC in these environments more comparable across latitudes. Thus, themagnitudes of SOC change across temperature gradients were non-uniformand depended on landform type. Additional factors that appeared to be related to SOC distribution within ecoregions included stand age, aspect, and permafrost presence or absence in black spruce stands. Overall, these results indicate the influence of major interactions between temperature-controlled decomposition and topography on SOC in high-latitude systems. However, there remains a need for more SOC data from wetlands and boreal-region permafrost soils, especially at depths\u3e1 m in order to fully understand the effects of climate on soil carbon in Alaska

Large birds travel farther in homogeneous environments

Aim: Animal movement is an important determinant of individual survival, population dynamics and ecosystem structure and function. Nonetheless, it is still unclear how local movements are related to resource availability and the spatial arrangement of resources. Using resident bird species and migratory bird species outside the migratory period, we examined how the distribution of resources affects the movement patterns of both large terrestrial birds (e.g., raptors, bustards and hornbills) and waterbirds (e.g., cranes, storks, ducks, geese and flamingos). Location: Global. Time period: 2003–2015. Major taxa studied: Birds. Methods: We compiled GPS tracking data for 386 individuals across 36 bird species. We calculated the straight‐line distance between GPS locations of each individual at the 1‐hr and 10‐day time‐scales. For each individual and time‐scale, we calculated the median and 0.95 quantile of displacement. We used linear mixed‐effects models to examine the effect of the spatial arrangement of resources, measured as enhanced vegetation index homogeneity, on avian movements, while accounting for mean resource availability, body mass, diet, flight type, migratory status and taxonomy and spatial autocorrelation. Results: We found a significant effect of resource spatial arrangement at the 1‐hr and 10‐day time‐scales. On average, individual movements were seven times longer in environments with homogeneously distributed resources compared with areas of low resource homogeneity. Contrary to previous work, we found no significant effect of resource availability, diet, flight type, migratory status or body mass on the non‐migratory movements of birds. Main conclusions: We suggest that longer movements in homogeneous environments might reflect the need for different habitat types associated with foraging and reproduction. This highlights the importance of landscape complementarity, where habitat patches within a landscape include a range of different, yet complementary resources. As habitat homogenization increases, it might force birds to travel increasingly longer distances to meet their diverse needs.National Trust for Scotland; Penguin Foundation; The U.S. Department of Energy, Grant/Award Number: DE-EE0005362; Australian Research Council; NASA's Arctic Boreal Vulnerability Experiment (ABoVE), Grant/Award Number: NNX15AV92A; Netherlands Organization for Scientific Research, Grant/Award Number: VIDI 864.10.006; BCC; NSF Award, Grant/Award Number: ABI-1458748; U.K. Department for Energy and Climate Change; ‘Juan de la Cierva ‐ Incorporación’ postdoctoral grant; Irish Research Council, Grant/Award Number: GOIPD/2015/81 ; DECC; Goethe International Postdoctoral Programme, People Programme (Marie Curie Actions) of the European Union's Seventh Framework Programme FP7/2007‐2013/ under REA grant agreement no [291776]; German Aerospace Center Award, Grant/Award Number: 50JR1601; Scottish Natural Heritage; Solway Coast AONB Sustainable Development Fund; COWRIE Ltd.; Heritage Lottery Fund; Robert Bosch Stiftung; NSF Division of Biological Infrastructure Award, Grant/Award Number: 1564380; Spanish Ministry of Economy and Competitiveness, Grant/Award Number: IJCI-2014-19190; Energinet.dk; NASA Award, Grant/Award Number: NNX15AV92A; MAVA Foundation; Fundação para a Ciência e Tecnologia, Grant/Award Number: SFRH/BPD/118635/2016; National Key R&D Program of China, Grant/Award Number: 2016YFC0500406; Green Fund of the Greek Ministry of Environmen